The Caribbean island of St. Martin is reporting two cases of the mosquito-borne viral illness Chikungunya with 34 additional probable or suspect cases. This is an important story because, to date, this virus had not been found in the Caribbean. Chikungunya is infamous for causing a large outbreak on the Reunion Islands in 2006 (after importation from Kenya) that went on to spread to various nations of Asia and Europe.

This virus is transmitted by the Aedes mosquito which is widely distributed in both the Caribbean and the US. It is also the vector for dengue and yellow fever. While 2 cases of chikungunya might represent recognition of travelers infected elsewhere--as has been reported in the US--34 cases are likely the result of autochthonous (local) transmission.

As such, these cases in St. Martin may represent the tip of the iceberg. It would not be surprising to find more cases in other Caribbean islands or even on the US mainland were Aedes mosquitoes abound and are readily available to bite viremic travelers.